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Showing content from https://pubmed.ncbi.nlm.nih.gov/22711724/ below:

Feasibility of evaluating the CHIPRA care quality measures in electronic health record data

Affiliations

• ¹ aKaiser Permanente Northwest Center for Health Research, Portland, Oregon, USA. rachel.gold@kpchr.org

• PMID: 22711724
• PMCID: PMC3382922
• DOI: 10.1542/peds.2011-3705

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Rachel Gold et al. Pediatrics. 2012 Jul.

• ¹ aKaiser Permanente Northwest Center for Health Research, Portland, Oregon, USA. rachel.gold@kpchr.org

• PMID: 22711724
• PMCID: PMC3382922
• DOI: 10.1542/peds.2011-3705

Item in Clipboard

The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) includes provisions for identifying standardized pediatric care quality measures. These 24 "CHIPRA measures" were designed to be evaluated by using claims data from health insurance plan populations. Such data have limited ability to evaluate population health, especially among uninsured people. The rapid expansion of data from electronic health records (EHRs) may help address this limitation by augmenting claims data in care quality assessments. We outline how to operationalize many of the CHIPRA measures for application in EHR data through a case study of a network of >40 outpatient community health centers in 2009-2010 with a single EHR. We assess the differences seen when applying the original claims-based versus adapted EHR-based specifications, using 2 CHIPRA measures (Chlamydia screening among sexually active female patients; BMI percentile documentation) as examples. Sixteen of the original CHIPRA measures could feasibly be evaluated in this dataset. Three main adaptations were necessary (specifying a visit-based population denominator, calculating some pregnancy-related factors by using EHR data, substituting for medication dispense data). Although it is feasible to adapt many of the CHIPRA measures for use in outpatient EHR data, information is gained and lost depending on how numerators and denominators are specified. We suggest first steps toward application of the CHIPRA measures in uninsured populations, and in EHR data. The results highlight the importance of considering the limitations of the original CHIPRA measures in care quality evaluations.

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Females aged 16 to 24…

Females aged 16 to 24 identified as sexually active in 2009, as identified…

Females aged 16 to 24 identified as sexually active in 2009, as identified by the original and adapted measure definitions.

• Developing measures for pediatric quality: methods and experiences of the CHIPRA pediatric quality measures program grantees.

  Byron SC, Gardner W, Kleinman LC, Mangione-Smith R, Moon J, Sachdeva R, Schuster MA, Freed GL, Smith G, Scholle SH. Byron SC, et al. Acad Pediatr. 2014 Sep-Oct;14(5 Suppl):S27-32. doi: 10.1016/j.acap.2014.06.013. Acad Pediatr. 2014. PMID: 25169454

• Electronic health record tools to assist with children's insurance coverage: a mixed methods study.

  DeVoe JE, Hoopes M, Nelson CA, Cohen DJ, Sumic A, Hall J, Angier H, Marino M, O'Malley JP, Gold R. DeVoe JE, et al. BMC Health Serv Res. 2018 May 10;18(1):354. doi: 10.1186/s12913-018-3159-x. BMC Health Serv Res. 2018. PMID: 29747644 Free PMC article. Clinical Trial.

• Are pediatric quality care measures too stringent?

  Casciato A, Angier H, Milano C, Gideonse N, Gold R, DeVoe J. Casciato A, et al. J Am Board Fam Med. 2012 Sep-Oct;25(5):686-93. doi: 10.3122/jabfm.2012.05.120041. J Am Board Fam Med. 2012. PMID: 22956704 Free PMC article.

1. 1. Children’s Health Insurance Program Reauthorization Act of 2009. Pub L No. 111–3. 123 Stat 8. Available at: https://www.cms.gov/HealthInsReformforConsume/Downloads/CHIPRA.pdf. Accessed December 6, 2011
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4. 1. Dougherty D, Schiff J, Mangione-Smith R. The Children’s Health Insurance Program Reauthorization Act quality measures initiatives: moving forward to improve measurement, care, and child and adolescent outcomes. Acad Pediatr. 2011;11(suppl 3):S1–S10 - PubMed
5. 1. Agency for Healthcare Research and Quality. Initial Core Set of Children's Healthcare Quality Measures. 2009. Available at: http//www.ahrq.gov/chip/listtable.htm. Accessed December 6, 2011

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